Forum adverts like this one are shown to any user who is not logged in. Join us by filling out a tiny 3 field form and you will get your own, free, dakka user account which gives a good range of benefits to you: No adverts like this in the forums anymore. Times and dates in your local timezone. Full tracking of what you have read so you can skip to your first unread post, easily see what has changed since you last logged in, and easily see what is new at a glance. Email notifications for threads you want to watch closely. Being a part of the oldest wargaming community on the net. If you are already a member then feel free to login now.

They don't automatically buy the cheapest on the market. They evaluate the likely benefits in terms of life extension and quality versus cost.

Let's suppose there is a particular cancer and two drugs for it. Drug A costs £10 per treatment and has a 75% chance of success. Drug B costs £25 per treatment and has an 85% chance of success. Should both be licensed and under what guidance? That's the kind of evaluation they have to do.

Frazzled wrote:

Kilkrazy wrote:


In the UK a Doctor can only prescribe a medicine on the NHS if it has been licensed by NICE (the National Institute for Clinical Excellence.) This stops super expensive new drugs from being prescribed willy-nilly and bankrupting the system.

So if it could cure your cancer but its reallyexpensive you're screwed? Yep that is indeed NICE.

What is the difference between that and what we have now?

There was a woman in Oakland, Ca that jumped off a building in protest (if you want to call it that) because she could not get her cancer treatment from her provider.

NO DIFFERENCE WHATSOEVER, and the drugs will probably become available at a lower cost because of competition to create the best drugs, not the most expensive ones. If more people have access to health care in general (doesn't matter where the money comes from) their will be more customers by default for the pill companies.

What if there is no Drug A?

dietrich wrote:The problem is there's several debates going on at once.
1. What Obama has proposed is dumping another $1 trillion or so to provide coverage for uninsured.
2. What people want is some sort of national health care program combined with reform.

And the two are being combined, even by myself at some points.

While giving insurance to the uninsured, by the US gov't dumping $1 trillion into the system, helps those individuals, it doesn't overhaul or help the system. It's just spending tax dollars. And while that means there'd be fewer uninsured going to the hospital - how much will that affect overall cost in the system? How good is that health coverage? And why should employers still offer an benefit if there's a government program to fall back on?

I'd like to see the system improved. It can be and should be. I don't want the US gov't to take it over in an effort to reform it though.

Yeah, I think there's a reasonable amount of credit to be targetted at Obama for his health plan, it doesn't do anything to address the fundamental reasons US healthcare is so bad and so expensive. I mean, I think it's an absolute must to extend healthcare to all citizens but there's other very big problems facing your system, and they won't be solved without major reform.

What did you think about my proposal in my previous response? Where you cut out the middle man, and let people purchase their own insurance, introducing the competition to the system people seem to keep claiming is important (but strangely absent).

sebster wrote:What did you think about my proposal in my previous response? Where you cut out the middle man, and let people purchase their own insurance, introducing the competition to the system people seem to keep claiming is important (but strangely absent).

It couldn't be worse. On paper, it sounds fine, but I think there's some problems. What happens if someone is unemployed and can't afford it? Do they not get coverage? Do they have to pay for it out of pocket?

Part of the issue is that we don't know what we want out of health coverage. As someone said (Guiliani, maybe), we don't buy car insurance and expect it to pay for oil changes and car washes. Why do we expect that with health coverage?

To me, a good first step, would be extending major medical coverage to everyone for 'free' (our tax dollars would cover it, so it's not technically free). Whether that is in tax rebates, or whatever, it could work. The question is - what's considered major? A hospital stay? More than $10,000 in a year? More than $4,000 in a year? Hard to determine (and knowing the US gov't, it wouldn't be tied to inflation, so it'd stay stagnant and in 20 years, wouldn't do what it was intended to do), and not something that I have an answer for. And it would lead to other problems (if you need three surgeries, make sure they're all in one calendar year, etc.). Insurance rates for an employer are generally driven by one or two big events for employees. That's why it's cheaper to provide coverage to more people - it's spreading the risk around. That would reduce the cost to employers, and employees, and would also help cover the uninsured.

Frazzled wrote:What if there is no Drug A?

I suppose that NICE would have to judge it by similar criteria.

I don't think there should be free Health Care for all. I think there should just be free Health Care for me and it should be the best in the world. At least that is what I think.

Ahtman, there is no such thing as free health care, its always payed for or subsidized by someone or some group,
but my take on it is no I don't want universal health care, I don't really trust the US gov at all

Huffy wrote:Ahtman, there is no such thing as free health care

Well now you've gone and ruined my day. Hopefully some BonBons still in the fridge to go with this cigarette and Big Mac. That should make me feel better.

Edit: I just realized I was posting in the wrong health care thread.

Miguelsan wrote:

halonachos wrote:Well the thing is, in america you can get taken care of regardless of insurance or not. Homeless people and illegal immigrants are given hospital care despite lack of insurance. The end result is the hospital footing the bill and charging those with insurance more for care...

Last time I was there in Spain our national healthcare program was treating people regardless their origin and footing the bill. So I don´t get to see what´s the problem here.

M.

Well, see the materials use by the physicians who treat the patients must cost money as does the time the physicians give to treatment. So somewhere down the line, costs are being incurred nd paid for. I see this, I work hard to earn pay. I don't want my pay to help those who are unwilling to work or those who have failed down the line. If you dropped out or had a kid in high school that's your problem, not mine. I don't want to pay for healthcare for others, it may be good but I'm going to go for qualitative good and not quantitative. It is better for me to help myself and my family than it is to help some stranger(I think that his is either Bentham or Mills I'm not sure).

Another issue is this, the government has a wonderful way of screwing things up. So why on earth do I want them in charge of medical care? The answer is I don't.

In effect, the plan will help those without healthcare at the cost of those who are already insured and may cause those who aready have healthcare to lose their care.

I also look the possible cause and effect.
Government makes plan--> physicians don't accept plan--> government socializes healthcare--> quality goes down.


@reds8n.

That was my point, the current plan is not good. The new plan proposed is the same thing we have now, but with higher costs.

PS. America does have free clinics established in many cities to care for the homeless/poor. There aren't many but there are some.


Read and Dissect.

dietrich wrote:It couldn't be worse. On paper, it sounds fine, but I think there's some problems. What happens if someone is unemployed and can't afford it? Do they not get coverage? Do they have to pay for it out of pocket?

I'm guessing you didn't read all of my earlier post that you replied to. I said that a basic level of care would be established for all. This wouldn't just be for people out of work but for anyone on a sufficiently low income.

But once you start earning so much a year you are moved into private care. The move to private care is encouraged because the private system has benefits (shorter waiting periods for elective surgery, greater choice of doctors, nicer conditions in hospital such as your own room), and because once you start earning too much you are taxed if you don't have private care.

But the big, big difference is that the consumer chooses his own private insurer. This means the insurance companies that benefit right now from denying care based on technicalities would take severe hits to their brand and lose business for doing so. Once you have choice over your insurance the invisible hand would actually come into play, and start motivating insurers to provide value for the consumer.

Part of the issue is that we don't know what we want out of health coverage. As someone said (Guiliani, maybe), we don't buy car insurance and expect it to pay for oil changes and car washes. Why do we expect that with health coverage?

That's an interesting point. I'm not sure I agree with (possibly) Guiliani's implied point that doctor's appointments and the like, because preventative care is so much more important in medicine. But I certainly agree that there needs to be discussion on exactly what insurance is expected to cover.

But to shift that analogy slightly... why would you have your car insurance provided by your employer? It's your car, your responsibility. If your employer provided your car insurance he'd be motivated by nothing but keeping that cost as low as possible. Which means you end up with crappy car insurance provided by a company who's business model is to deny any and all claims. Instead, you have people buy their own car insurance and they're free to weigh up the costs of various plans against what they actually want. Why should healthcare be any different?

halonachos wrote:I don't want my pay to help those who are unwilling to work or those who have failed down the line. If you dropped out or had a kid in high school that's your problem, not mine. I don't want to pay for healthcare for others, it may be good but I'm going to go for qualitative good and not quantitative.

Well sorry, Mr. Reagan, but it's really not that simple. The American myth of "welfare queens" and those who are "unwilling to work" gets me every time. Homeless people with "WILL WORK FOR FOOD" signs seem pretty willing, but you won't pay for their healthcare, will you?

Honestly, the stupid propaganda about "government bureaucrats who decide what you get, NOT THE DOCTORS!" is worthless fearmongering. They fail to mention that not only are insurance companies already doing the same (with the incentive of profit to rip you off), and that you're already paying them to do it. Sometimes people seem so afraid of taxes that they fail to see that paying money to a company is about the same as paying it to the government if you get the same thing out of it. Not to mention that countries with socialized medicine have lower overhead costs than American health insurance companies.

I hate to say it, but eventually we've gotta drop the stupid individualist cowboy crap. Not as in "everyone dress like Mao." More like it's ok to help your neighbor out if he needs it now, since he'll do the same if you need it later. We aren't all pioneers anymore with no one around for miles.

No one tell Texas, though. That would break their John Wayne loving hearts (kidding),

First I´ll say that I´m not up to date in the exact plan that Mr Obama and the Congress are negotiating. But on the general issue of Social vs. Private care I have a few things to comment on Halonachos´post

halonachos wrote:
Well, see the materials use by the physicians who treat the patients must cost money as does the time the physicians give to treatment. So somewhere down the line, costs are being incurred nd paid for. I see this, I work hard to earn pay. I don't want my pay to help those who are unwilling to work or those who have failed down the line. If you dropped out or had a kid in high school that's your problem, not mine. I don't want to pay for healthcare for others, it may be good but I'm going to go for qualitative good and not quantitative. It is better for me to help myself and my family than it is to help some stranger(I think that his is either Bentham or Mills I'm not sure).

Nice argument here, the old and true the poor are to blame for being poor. Well let me tell you that the dropouts and teenager moms are already receiving other things from the US government that you are "paying" for like security, defense, etc... Think about how much quality would you get in police protection if somehow you could disfranchise all these people from the system.
In an ideal health care plan (I don´t know if this one will be) an extension of the benefits to non insuranced people doesn´t have to cost you a dime. As I already pointed you are already paying taxes for "free services" to the State like defense, transportation, justice. So the State has two options, either rise additional taxes as everybody against the plan seems to think or divert resources from the other areas of the budget as the money is already there. The US citizens will have to ask themselves what they want:a national health care system or more fighter planes, a department of Homeland Security or Transportation. Check the 2008 budget and think which areas overlap, are superfluous or could shed some money to health care.
http://en.wikipedia.org/wiki/United_States_federal_budget,_2008

In effect, the plan will help those without healthcare at the cost of those who are already insured and may cause those who aready have healthcare to lose their care.
I also look the possible cause and effect.
Government makes plan--> physicians don't accept plan--> government socializes healthcare--> quality goes down.

Quite a bold affirmation here, specially if like in some countries with socialized health care you are getting treated in the same place, with the same doctors and the same equipment, the only difference being who is footing the bill.

Another issue is this, the government has a wonderful way of screwing things up.

This is the only part of the message I agree with you. But even screwed up, somethings are a necessity.

M.



Automatically Appended Next Post:

Mad Rabbit wrote:
I hate to say it, but eventually we've gotta drop the stupid individualist cowboy crap. Not as in "everyone dress like Mao." More like it's ok to help your neighbor out if he needs it now, since he'll do the same if you need it later. We aren't all pioneers anymore with no one around for miles.

Sometimes when I read the news I wonder if that´s not the default setting of most US guys.

M.

halonachos wrote:
I also look the possible cause and effect.
Government makes plan--> physicians don't accept plan--> government socializes healthcare--> quality goes down.

Why would any physician ever refuse national insurance? All it does from their perspective is provide a means of receiving payment for services they are currently required to render for free.

halonachos wrote:

Another issue is this, the government has a wonderful way of screwing things up. So why on earth do I want them in charge of medical care? The answer is I don't.

...

If governments screw everything up, why would you want them in charge of defence, law & order and national standards for weights and measures?

halonachos wrote:
In effect, the plan will help those without healthcare at the cost of those who are already insured and may cause those who aready have healthcare to lose their care.

...

If done right it might help everyone. There isn't any western nation with a nationalised healthcare system where people who used to be rich have become poor and lost their healthcare thanks to universal coverage.

Advantages in a national system include bulk-buying of materials at discount prices, for example, and reduced accountancy overheads.

The base fact is the USA spends 15% of GDP on healthcare, which is about 50% more than most western countries, yet many indicators of public health are worse.

halonachos wrote:
I also look the possible cause and effect.
Government makes plan--> physicians don't accept plan--> government socializes healthcare--> quality goes down.

The UK faced the same problem in 1948, and it was solved by:
Government makes plan in counsultation with doctors--> physicians accept plan--> government socializes healthcare--> quality goes up.


I hope it doesn't seem I have quoted too selectively.

Now here's the thing, the defense and security budget benefits all americans while welfare only affects those who are in the bottom classes of american society.

This little website has some reasons for my attitude towards socialized medicine.http://www.cato.org/pubs/catosletter/catosletterv3n1.pdf


To save some reading.

In the United States there are about 14 million people—
more than a third of the uninsured—who are,
in principle, eligible to get free medical care by
joining either the Medicaid program or the State
Children’s Health Insurance Program. And yet they
don’t bother to enroll.

If you’re the hundredth
person waiting for heart surgery,
you’re not entitled to
the hundredth surgery. Other
people can and do get in ahead
of you. From time to time, even
Americans go to Canada and jump
the queue, because Americans can do
something that Canadians cannot—Americans
can pay for care. Canadian hospitals love
to admit American patients, because that
means cash into their budgets.

In Britain, the typical general
practitioner barely has time to take your
temperature and write a prescription. And
even if they discover something wrong with
you, they may not have the technology to
solve your problem.
Among people with chronic renal failure,
only half as many Canadians as Americans
get dialysis, and only a third as many
Britons on a per capita basis. The American
rate of coronary bypass surgeries is
three or four times what it is in Canada,
and five times what it is in Britain.

halonachos wrote:Now here's the thing, the defense and security budget benefits all americans while welfare only affects those who are in the bottom classes of american society.

Duh, that's what welfare is.

This little website has some reasons for my attitude towards socialized medicine.http://www.cato.org/pubs/catosletter/catosletterv3n1.pdf

Ah, I see. You read the Cato Institute, that's goes a long way to explaining your views.

For the record, those guys make the Austrian School economists blush.

In the United States there are about 14 million people—
more than a third of the uninsured—who are,
in principle, eligible to get free medical care by
joining either the Medicaid program or the State
Children’s Health Insurance Program. And yet they
don’t bother to enroll.

Yep... straw man argument, the system sucks in a way that is unfathomable to most. I think this is the epitome of greed, and it is a serious problem for our nation. Our overspending on stuff like big tv's and fancy cars has taken any sense of rationality for other things. If a TV is more important than a persons life, more importantly a CHILDS LIFE, you need to be... never mind, have a nice day and blablabla

In Britain, the typical general
practitioner barely has time to take your
temperature and write a prescription.

Utter rot.

welfare only affects those who are in the bottom classes of american society.

The point your missing therefore being that it does affect your society as a whole.

Geez how hard is that to understand.


PLus, if your kid is dying of cancer and you can't afford the treatment I fail to see how the security and armed forces are benefitting you at all. In that situation you'd have a lot to gain from, say, a revolution. Hmm.. the dispossessed and the underclasses rising up against a system that actively conspires to keep them down...I reckon there's a book in that.

Americans can do
something that Canadians cannot—Americans
can pay for care.

Not true at all either. Whilst some of the states in canada did outlaw private treatment a Quebec supreme court order ruling in2005 made it quite legal to buy private treatment.

Also... how are American;s going to canada to buy treatment then if this isn't possible.

Also the changes proposed to your system (from everything I've read, I'm "happy" to be shown otherwise) would not prevent people who are stil wealthy enough to buy their own treatment from doing so.

Yes, and I don't believe in welfare. Throwing money at your problems doesn't solve anything.

I'm going to go and say this: I believe that I should decide what I want my money to be spent on and it shouldn't be distributed all willy-nilly to causes I don't support.

I would rather the government took my money and bought some run down houses and improved them. Take homeless people and let them live in said houses but here's the catch, the people living in the houses have to work to maintain the housing complex and are paid by the government. This program will also offer a program to help those without a high school diploma receive their GED.

I would support a program that would have long term effects instead of long term costs only. Welfare just gives money.

Give a man a fish feed him for a day. Teach a man to fish feed him for life.



But back to healthcare, I don't care how they're rated about their economic rantings. Some of the things about quality of care ring true.

A russian immigrant came to our house to steam our carpets once. He saw the healthcare issue on TV and said "Why the hell do you americans want that? We had it in russia and I'll tell you this... If you went to a dentist it hurt, but if you had money it didn't hurt."

@ reds8n
The plan and healthcare we currently have is the same as the plan Obama is working on just that those uninsured people are called insured. Changing a label for a billion dollars is not a fair deal.


Automatically Appended Next Post:
I believe in a fair tax. No tax for necessities only for luxuries. I've seen "poor" people with $100 shoes. I go to steve and barry's and pay $7.


Automatically Appended Next Post:
Anyway I got to go buy a textbook for my college classes because I got to work hard, thousands on welfare depend on me.

halonachos wrote:Give a man a fish feed him for a day. Teach a man to fish feed him for life.

Applying this rationally to the current state of affairs in the U.S. is like saying that... wait so you wouldn't pay for that either? Am I missing something here?

I have read so much bigoted stuff recently I really do not want to tag you as one by my present state of mind. That said I do agree that there should be work on the "welfare" system throughout the country. The whole idea that most people wouldn't want a part of a good program is totally ludicrous.

Okay... I have seen these programs start up and fail. Why you may ask? Were the people involved not involved enough? Would you actually accuse some of these people (a lot of which help out of good will) that they were not doing there jobs (screw your elite standard of excellence, this is just life man, not the olympics) and therefor deserved to not get funding?

Places like this are still going to take money out of your pocket as you put it, and the government will mess them up so bad through corruption and genuine theft that it would become a 3 little pigs scenario where you end up with a revolutionary brick and mortar force TAKING what they feel they deserve.

halonachos wrote:Anyway I got to go buy a textbook for my college classes because I got to work hard, thousands on welfare depend on me.

Hmmm... I am not sure you know what you are talking about... stop paying your taxes if you care that much. Better yet see how much it costs to help support that single mom with kids going to school, while working two jobs.... AAAAAARRRRRRrrrgggghhh!!!

You make me pretty angry dude.

@halonachos

What I don't understand is this: You know from facts that the USA spends considerably more of its money on healthcare than comparable western nations (Canada, UK, Denmark) yet generates worse outcomes on a number of measures.

Do you think that "socialised medicine" would cost you as a taxpayer more than the current US system, or that it would cost the same but produce even worse results?

If it cost less, but produced worse results, you as a taxpayer would have more money left to go private.

Your idea about letting the government pay people to refurbish run-down houses is not a bad one as such, but it will be taking work away from private builders.

ITT: 14 year olds watch sean hannity, know nothing about foreign healthcare systems, don't understand the ideas being put foreward for our own system, and link to BS blog articles which are little more than anti communist propaganda with the word healthcare thrown in a few dozen times.


Shocker.



Though its nice to see the socialists rush out to shout down all the insults Bill "Maybe I'm just not a smart guy" O'rielly has been throwing out.

Kilkrazy wrote:Your idea about letting the government pay people to refurbish run-down houses is not a bad one as such, but it will be taking work away from private builders.

Did you say work?

There is actually a very large amount of construction going on in my area recently. 2 new supermarkets have been built, and at least 3 new very large apartment buildings in or around the downtown area.

The funniest thing is that any extra jobs are usually going to go the migrant workers that hang out near the fancy area, kind of weird actually. It is like a one stop shop for yuppies, and I cannot hate on the hard-working migrant workers, they are a pleasure to work with most of the time.

I believe that I should decide what I want my money to be spent on

Everyone thinks that and it is impossible*. the closest we get is by electing Govts and then they do their thing.

You can't have a tax system by plebiscite.

It would be quite hard to fight a war that wasn't popular for example.


* Possible exception, not sure if this still/ever applies : did the Amish or some such group get something odd with their taxes and military spending ?

government took my money and bought some run down houses and improved them.

Council houses you mean ? Careful, that's verging towards socialism.

I would support a program that would have long term effects

Like feeding, providing housing and medical care for poor children you mean.
You're more communist than we thought.

halonachos wrote:Yes, and I don't believe in welfare. Throwing money at your problems doesn't solve anything.

It frequently does just that. The real issues involve not having money to throw, or not knowing where to throw it.

halonachos wrote:
Give a man a fish feed him for a day. Teach a man to fish feed him for life.

You know there's a middle ground there. Where you feed the man when he can't feed himself, while teaching him how to do so in the future.

halonachos wrote:
I believe in a fair tax. No tax for necessities only for luxuries. I've seen "poor" people with $100 shoes. I go to steve and barry's and pay $7.

Cool. I've seen wealthy people pay homeless men to fight each other. Therefore all wealthy people are immoral jerks.

halonachos wrote:I believe in a fair tax. No tax for necessities only for luxuries. I've seen "poor" people with $100 shoes. I go to steve and barry's and pay $7.

I don't even want to know how you KNEW they were poor, or why it matters to you either way, shoes are shoes, not cars and yachts...

reds8n wrote:

government took my money and bought some run down houses and improved them.

Council houses you mean ? Careful, that's verging towards socialism.

I would support a program that would have long term effects

Like feeding, providing housing and medical care for poor children you mean.
You're more communist than we thought.

Okay, listen. This medical care thing is ALREADY established in america and those without insurance would get the same care they get not even if they were insured. The hippocratic oath ensures that care will be given by a trained proffessional. The same illegal immigrant who received thousands of dollars worth of drugs because he decided to get coked up got the same quality of care that a young woman with insurance who was in an automobile accident received.

With my quotes, I would rather the government take my money towards those housing complexes maintained by those that live in them(hell why not have them build some new houses as well), rathar than just give it to some down on their luck woman or man or family. I would much rather have a privately run version of this, but seeing as though the government is already taking the money they might as well start it and then pass it to someone else so that it is privately run.

@ Wrexasaur

Speak to Thoreau. He believed that if he didn't believe in a cause he shouldn't have to pay for it , but he could decide to donate to whatever he did support. He even argued what if he didn't want to support anything at all. Ayn Rand Spoke for individualism and warned against serving others completely or even at all.

I believe in some causes and not in others, its that simple. Welfare doesn't work so I don't want to support it. I fear that this "new" program is more or less the same just with a higher cost for the country. Obama may even go against his word and raise taxes on middle class families to do so.

And when you teach a man to fish he catches fish and can eat it, that's the whole idea of it. I believe that education is the answer, not money.

I know welfare sucks and I know that even the healthcare given to military family sucks, I've dealt with both.



Automatically Appended Next Post:
Buying shoes that are $100 is a luxury and if a person is struggling they should not be buying $100 shoes. A fair tax puts a sales tax on luxury items such as TV, Candies, Warhammer figures, etc. While leaving basic clothing, food, water, milk, etc tax free. As to how I know they're poor, I live next door to them.


Automatically Appended Next Post:

dogma wrote:
Cool. I've seen wealthy people pay homeless men to fight each other. Therefore all wealthy people are immoral jerks.

Good thing I'm not wealthy, or that would be ad hominem and make your point invalid.

What I see is a straw man argument that could have been applied a few decades ago, but simply not in the same way today.

Something about a cricket and an ant or something... just a thought. I have moved mountains but the end result is just a mountain in someone else way, and goddam was that hard as hell. I think the ant could have made some sort of deal with the cricket, especially since the cricket would have been a fantastic partner to work with. Laziness taken into todays standards is getting through high school and maintaining a minimum wage job for your whole life. The whole thing is just riddled with clear and present fallacies.

I am going to have to step out of this conversation until I feel I have calmed down a bit (you did flip-flop a bit there) and I can make sure to keep this as civil as possible.

flip flop sure, to be inconsistent is to be human. I believe in some things and not others, surely you do the same?


Automatically Appended Next Post:
I don't believe I am reading your standing incorrectly. You do believe that we should have universal/nationalized healthcare and that it comes to a benefit for everyone,so we should have it because it makes the system better, am I correct?